3D-image-guided HDR-brachytherapy versus 2D HDR - brachytherapy after external beam radiotherapy for early T-stage nasopharyngeal carcinoma.
3D-image-guided HDR-brachytherapy versus 2D HDR - brachytherapy after external beam radiotherapy for early T-stage nasopharyngeal carcinoma.
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早期 T 期鼻咽癌外照射放疗后 3D 图像引导 HDR 近距离放射治疗与 2D HDR 近距离放射治疗的比较
DOI：
10.1186/1471-2407-14-894
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发表时间：
2014-11-29
期刊：
影响因子：
3.8
通讯作者：
Wen B
中科院分区：
文献类型：
--
作者：
Ren Y;Zhao Q;Liu H;Huang Y;Wang Z;Cao X;Teh BS;Wen B
背景：二维高剂量率近距离放射治疗（2D-HDR-BT）是早期T期鼻咽癌局部控制的有效剂量递增方法。尚未在早期T期NPC患者中检查外部射束放疗（ERT）后3D图像引导高剂量率近距离放射治疗（3D图像引导HDR BT）的治疗结局。目前的研究旨在评估是否添加3D-HDR-BT的ERT显示进一步改善治疗结果的早期T期鼻咽癌患者相比，2D-HDR-BT后ERT.Methods：目前的研究回顾性分析和比较治疗结果与2D-HDR-BT（n =101）或3D-HDR-BT（n =118）后ERT的非转移性T1-2b期鼻咽癌患者。两组患者均接受ERT治疗，平均剂量为60戈伊，近距离放射治疗剂量为12戈伊（8 ~ 20戈伊），2.5 ~ 5戈伊/次，局部麻醉下。结果：与ERT后接受2D-HDR-BT治疗的患者相比，ERT后接受3D-HDR-BT治疗的患者在5年精算局部控制生存率（p = 0.024）、局部/区域无复发生存率（p = 0.038）和无病生存率（p = 0.021）方面均有改善。多变量分析显示，接受3D-HDR-BT治疗的NPC患者改善了局部控制生存率（p = 0.042）。两组急性或慢性并发症的发生率相似。结论：目前的研究表明，3D图像引导下的HDR-BT后ERT是一种有效的治疗模式，T1-2期鼻咽癌患者的并发症可接受。局部肿瘤控制和无病生存率的改善可能是由于适形剂量分布的改善。
Background:Two-dimensional high-dose-rate brachytherapy (2D-HDR-BT) is an effective method of dose escalation for local tumor control in early T-stage nasopharyngeal carcinoma (NPC). Treatment outcomes for 3D-image-guided high-dose-rate brachytherapy (3D-image-guided-HDR-BT) after external beam radiotherapy (ERT) have not been examined in early T-stage NPC patients. The current study was designed to evaluate whether addition of 3D-HDR-BT to ERT showed further improvement in treatment outcomes in patients with early T-stage NPC when compared to 2D-HDR-BT after ERT.Methods:The current study retrospectively analyzed and compared treatment outcomes for patients with nonmetastatic stage T1-2b NPC treated with 2D-HDR-BT (n =101) or 3D-HDR-BT (n =118) after ERT. Patients in both groups were treated with ERT at a mean dose of 60 Gy and a brachytherapy dose of 12Gy (8 ~ 20Gy), 2.5 ~ 5Gy per fraction under local anesthesia.Results:Compared to patients treated with 2D-HDR-BT after ERT, patients treated with 3D-HDR-BT after ERT showed improvement in five-year actuarial local control survival rates (p = 0.024), local/regional relapse-free survival rates (p = 0.038), and disease-free survival rates (p = 0.021). Multivariate analysis showed that NPC patients treated with 3D-HDR-BT had improved local control survival (p = 0.042). The incidence rates of acute or chronic complications were similar between two groups.Conclusions:The current study showed that 3D-image-guided HDR-BT after ERT was an effective treatment modality for patients with stage T1-2 NPC with acceptable complications. The improvement in local tumor control and disease free survival is likely due to improved conformal dose distributions.
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影响因子：
1.9
作者：
Levendag, Peter C.;Keskin-Cambay, Fatma;Teguh, David N.
通讯作者：
Teguh, David N.
影响因子：
1.2
作者：
Osewski, Wojciech;Dolla, Lukasz;Slosarek, Krzysztof
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DOI：
10.1016/s0360-3016(99)00326-0
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2000-01-15
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51.1
作者：
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作者：
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通讯作者：
Smith PG